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General NPI Number Information
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NPI Number | 1780883108
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Entity Type | Organization
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Legal Business Name | YARA VARGAS MD PLC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 2919 S ELLSWORTH RD STE 117
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City | MESA
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State | AZ
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Zip | 85212-2166
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Country | US
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Telephone | 480-365-0557
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Fax | 480-365-0996
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Provider Business Mailing Address
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Address Line | 2919 S ELLSWORTH RD STE 117
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City | MESA
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State | AZ
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Zip | 85212-2166
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Country | US
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Telephone | 480-365-0557
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Fax | 480-365-0996
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. REAJ VIRGINIA ROBERTS
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Credential |
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Telephone | 602-214-6154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 33846
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License Number State | AZ
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